VA Claim Resource Pack

PTSD

Example for service-connected post-traumatic stress disorder tied to an in-service stressor.

NEXUS LETTER (DRAFT — to be reviewed, completed, and signed by a qualified clinician)

Re: Medical nexus opinion for the veteran's PTSD.

1. In-service event/stressor: [Describe the in-service stressor, with dates and location, as reported by the veteran.]

2. Current diagnosis: The veteran has a current diagnosis of PTSD, diagnosed by [clinician/credentials] on [date].

3. Medical opinion (nexus) — TO BE COMPLETED BY THE REVIEWING CLINICIAN:
It is [CLINICIAN TO SELECT: not likely / at least as likely as not / more likely than not] that the veteran's PTSD is related to the in-service stressor described above.

Rationale: [CLINICIAN TO COMPLETE — reference the records reviewed and the clinical basis.]

[CLINICIAN NAME], [CREDENTIALS], [DATE], [SIGNATURE]

This is a draft prepared from the veteran's account and must be independently reviewed and signed by a qualified clinician before use.

Sleep apnea (often secondary to PTSD)

Example for obstructive sleep apnea claimed as secondary to a service-connected condition such as PTSD.

NEXUS LETTER (DRAFT — to be reviewed, completed, and signed by a qualified clinician)

Re: Medical nexus opinion for the veteran's obstructive sleep apnea, claimed as secondary to [service-connected condition, e.g. PTSD].

1. Service-connected condition: The veteran is service-connected for [condition] at [rating]%.

2. Current diagnosis: The veteran has a current diagnosis of obstructive sleep apnea, confirmed by sleep study on [date].

3. Medical opinion (secondary nexus) — TO BE COMPLETED BY THE REVIEWING CLINICIAN:
It is [CLINICIAN TO SELECT: not likely / at least as likely as not / more likely than not] that the veteran's sleep apnea was caused or aggravated by the service-connected [condition].

Rationale: [CLINICIAN TO COMPLETE — cite the medical literature and the clinical basis for the secondary relationship.]

[CLINICIAN NAME], [CREDENTIALS], [DATE], [SIGNATURE]

This is a draft and must be independently reviewed and signed by a qualified clinician before use.

Tinnitus

Example for tinnitus linked to in-service noise exposure.

NEXUS LETTER (DRAFT — to be reviewed, completed, and signed by a qualified clinician)

Re: Medical nexus opinion for the veteran's tinnitus.

1. In-service event: [Describe the in-service noise exposure — e.g. artillery, aircraft, or weapons fire — with dates and location, as reported by the veteran.]

2. Current diagnosis: The veteran has a current diagnosis of tinnitus, diagnosed by [audiologist/credentials] on [date].

3. Medical opinion (nexus) — TO BE COMPLETED BY THE REVIEWING CLINICIAN:
It is [CLINICIAN TO SELECT: not likely / at least as likely as not / more likely than not] that the veteran's tinnitus is related to the in-service noise exposure described above.

Rationale: [CLINICIAN TO COMPLETE.]

[CLINICIAN NAME], [CREDENTIALS], [DATE], [SIGNATURE]

This is a draft and must be independently reviewed and signed by a qualified clinician before use.

Generic / other conditions

A blank template structure you can adapt for any other condition.

NEXUS LETTER (DRAFT — to be reviewed, completed, and signed by a qualified clinician)

Re: Medical nexus opinion for the veteran's [condition].

1. In-service event/injury/illness: [Describe the in-service event, with dates and location, as reported by the veteran.]

2. Current diagnosis: The veteran has a current diagnosis of [condition], diagnosed by [clinician/credentials] on [date].

3. Medical opinion (nexus) — TO BE COMPLETED BY THE REVIEWING CLINICIAN:
It is [CLINICIAN TO SELECT: not likely / at least as likely as not / more likely than not] that the veteran's [condition] is related to the in-service event described above.

Rationale: [CLINICIAN TO COMPLETE.]

[CLINICIAN NAME], [CREDENTIALS], [DATE], [SIGNATURE]

This is a draft and must be independently reviewed and signed by a qualified clinician before use.

Claim-preparation tips

A few practical steps that tend to make a self-prepared claim stronger:

1. Gather your evidence first: your DD-214, service treatment records, and any current medical records that show a diagnosis and ongoing treatment.
2. Connect the dots: for each condition, be able to show a current diagnosis, an in-service event or exposure, and a medical link between the two.
3. Look for secondary conditions: a service-connected condition can cause or worsen others (for example, sleep apnea or depression secondary to PTSD).
4. Take any draft nexus letter to a qualified clinician to review against your records, complete, and sign — an unsigned draft is not competent medical evidence.
5. Consider free help: a VA-accredited VSO can prepare and file your claim at no cost. Verify accreditation before you trust anyone with your claim.